Site Activity
This page provides a monthly listing of publication activity on the Medical Policy Portal including Policy Notifications, New Policies, Updated Policies, Coding Updates, Reissued Policies, and Archived Policies. To view publication activity from prior months, select Past Site Activity.

Past Site Activity
 
                                                                                                        

Notifications
The following Independence Blue Cross Medicare Advantage policies have been posted prior to their effective date.
MA08.091, Aprepitant (Cinvanti™), Fosaprepitant Dimeglumine (Emend®), Granisetron (Sustol®), and Rolapitant (Varubi®)
Notification: 10/03/2017 (Revised 11/02/2017 , 11/07/2017, amd 11/16/2017) | Effective: 01/01/2018 | Posted: 10/03/2017
Type of policy change: This is a new policy.

MA00.047, Musculoskeletal Services
Notification: 10/03/2017 (Revised 11/02/2017) | Effective: 01/02/2018 | Posted: 10/03/2017
Type of policy change: This is a new policy.

MA11.113, Percutaneous Coronary Intervention, Coronary Angiography and Arterial Ultrasound
Notification: 10/03/2017 | Effective: 01/02/2018 | Posted: 10/03/2017
Type of policy change: This is a new policy.

MA00.002e, Continuous Glucose Monitors and Artificial Pancreas Device Systems (APDS)
Notification: 10/04/2017 | Effective: 11/03/2017 | Posted: 10/04/2017

MA05.067, Leadless Pacemakers
Notification: 10/04/2017 | Effective: 11/03/2017 | Posted: 10/04/2017
Type of policy change: This is a new policy.

MA06.025e, Presumptive and Definitive Drug Testing in Substance Abuse and Pain Management Treatments
Notification: 10/13/2017 | Effective: 01/01/2018 | Posted: 10/13/2017
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.092, Edaravone (Radicava™)
Notification: 10/18/2017 | Effective: 11/17/2017 | Posted: 10/18/2017
Type of policy change: This is a new policy.

MA08.007i, Medicare Part B vs. Part D Crossover Drugs
Notification: 10/18/2017 | Effective: 11/17/2017 | Posted: 10/18/2017
Type of policy change: Coverage and/or Reimbursement Position; Medical Coding


New Policies
The following Medicare Advantage policies have been newly developed to communicate coverage and/or reimbursement positions, reporting requirements, and other processes and procedures for doing business with Independence Blue Cross.
MA10.008, Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD)
Effective: 10/04/2017 | Posted: 10/04/2017
Type of policy change: This is a new policy.


Updated Policies
The following Medicare Advantage policies have been reviewed and updated to communicate current coverage and/or reimbursement positions, reporting requirements, and other procedures for doing business with Independence Blue Cross.
MA07.010a, Biofeedback Therapy
Effective: 10/06/2017 | Posted: 10/06/2017
Type of policy change: General Description, Guidelines, or Informational Update

MA11.099a, Septoplasty, Rhinoplasty, and Septorhinoplasty
Notification: 07/12/2017 | Effective: 10/10/2017 | Posted: 10/10/2017
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding

MA08.022d, Rituximab (Rituxan®) infusion, and rituximab and hyaluronidase human (Rituxan Hycela™) for subcutaneous injection
Effective: 10/18/2017 | Posted: 10/18/2017
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.066b, Ado-Trastuzumab Emtansine (Kadcyla®)
Effective: 10/18/2017 | Posted: 10/18/2017
Type of policy change: Medical Necessity Criteria

MA08.015c, Alemtuzumab (Lemtrada™)
Effective: 10/18/2017 | Posted: 10/18/2017
Type of policy change: Medical Necessity Criteria

MA08.073e, Intravitreal Injection of Vascular Endothelial Growth Factor (VEGF) Antagonists (e.g., ranibizumab [Lucentis®], pegaptanib sodium [Macugen®], aflibercept [Eylea®], and related biosimilars)
Notification: 09/29/2017 | Effective: 10/30/2017 | Posted: 10/30/2017
Type of policy change: Coverage and/or Reimbursement Position; Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update

MA08.004h, Coagulation Factors
Notification: 09/29/2017 | Effective: 10/30/2017 | Posted: 10/30/2017
Type of policy change: Medical Necessity Criteria; Medical Coding; General Description, Guidelines, or Informational Update


Reissue Policies
The following Medicare Advantage policies have been reviewed, and no substantive changes were made.
MA05.034, Tracheostomy Care Supplies
Reissue Effective: 10/12/2017 | Reissue Posted: 10/12/2017

MA09.012a, Full-Body Computerized Tomography (CT) Scan Screening
Reissue Effective: 10/24/2017 | Reissue Posted: 10/24/2017


Coding Update
The following Medicare Advantage policies have been reviewed and updated to add new and revised medical codes (e.g., ICD-9 and ICD-10 diagnosis codes; CPT® and HCPCS codes; revenue codes) and/or remove terminated medical codes.
MA06.025d, Presumptive and Definitive Drug Testing in Substance Abuse and Pain Management Treatments
Effective: 10/01/2017 | Posted: 10/02/2017

MA06.012c, Genetic Testing for Inherited Susceptibility to Colon Cancer and Microsatellite Instability Testing (Familial Adenomatous Polyposis and Lynch Syndrome)
Effective: 10/01/2017 | Posted: 10/02/2017

MA06.031a, Vitamin D Assay Testing
Effective: 10/01/2017 | Posted: 10/02/2017

MA06.022c, Biomarkers for Oncology
Effective: 10/01/2017 | Posted: 10/02/2017

MA08.037c, Bortezomib (Velcade®)
Effective: 10/01/2017 | Posted: 10/02/2017

MA06.017j, Molecular Diagnostics
Effective: 10/01/2017 | Posted: 10/02/2017

MA00.003g, Preventive Care Services
Effective: 10/01/2017 | Posted: 10/03/2017

MA00.030j, Laboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products
Effective: 10/01/2017 | Posted: 10/03/2017

MA08.010g, Programmed Death Receptor-1 (PD-1) Antagonists (e.g., Keytruda®, Opdivo®) and Programmed Death-Ligand 1 (PD-L1) Antagonists (e.g., Tecentriq®, Bavencio®, Imfinzi™)
Effective: 10/01/2017 | Posted: 10/04/2017

MA07.033c, Nerve Conduction Studies (NCS) and Related Electrodiagnostic Studies
Effective: 10/01/2017 | Posted: 10/05/2017

MA00.007d, Obstetrical Ultrasounds for members enrolled in a Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) product
Effective: 10/01/2017 | Posted: 10/09/2017










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